SUSMITA BHOGINENI-THAKORE (NPI# 1972573178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972573178 |
| Entity Type | Individual |
| Full Name | SUSMITA BHOGINENI-THAKORE |
| Credential | MD |
| Practice Address |
650 N Nellis Blvd Las Vegas NV 89110 |
| Mailing Address |
Po Box 15645 Las Vegas NV 89114-5645 |
| Practice Telephone | 7024597424 |
| Practice Fax Number | 7024590320 |
| Mailing Telephone | 7025602879 |
| Mailing Fax Number | 7025602928 |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2010-03-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 11306 | NV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | 100506076 | 05 | |
| NV | 100506075 | 05 |
| Street Address |
650 N NELLIS BLVD |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184614372 | Ahmad N Saab | Family Medicine | 650 N Nellis Blvd, Las Vegas, NV 89110-5382 | 2005-10-27 |
| 1780218750 | Radford Raquedan | Nurse Practitioner | 650 N Nellis Blvd, Las Vegas, NV 89110-5382 | 2020-02-27 |
| 1346716057 | Darlene Teddy | Dentist | 650 N Nellis Blvd, Las Vegas, NV 89110 | 2018-10-19 |
| 1053895862 | Erika Liliana Coulson | Nurse Practitioner | 650 N Nellis Blvd, Las Vegas, NV 89110-5382 | 2018-09-18 |
| 1053847038 | Nevada Dental Benefits, Ltd. | Dentist | 650 N Nellis Blvd, 2nd Floor, Las Vegas, NV 89110-5382 | 2017-05-11 |
| 1154855419 | Brenda Arely Delgado | Nurse Practitioner | 650 N Nellis Blvd, Las Vegas, NV 89110-5382 | 2017-04-13 |
| 1023549177 | Activate Healthcare - Chc Nellis | Clinic/Center | 650 N Nellis Blvd, Las Vegas, NV 89110-5382 | 2017-03-21 |
| 1790137644 | Christine Anne Farren | Nurse Practitioner | 650 N Nellis Blvd, Las Vegas, NV 89110-5382 | 2016-07-04 |
| 1912362864 | Christopher Jack Mercer | Physician Assistant | 650 N Nellis Blvd, Las Vegas, NV 89110 | 2015-12-19 |
| 1447666755 | Tania Mathew | Family Medicine | 650 N Nellis Blvd, Las Vegas, NV 89110-5382 | 2014-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932740792 | Egalitarian Nevada LLC | Community/Behavioral Health | 241 North Nellis Boulevard, Suite 103, Las Vegas, NV 89110 | 2019-10-03 |
| 1730698333 | Antoinette Garrett | Rehabilitation Practitioner | 3085 S. Jones Boulevard Ste D., Las Vegas, NV 89110 | 2017-09-26 |
| 1063883486 | Chanfay Michelle Dabney | Adult Companion | 609 Sponseller, Las Vegas, NV 89110 | 2015-10-12 |
| 1689097735 | Lynda C Mccloskey | Registered Nurse | 330 South Valley View, Las Vegas, NV 89110 | 2014-01-27 |
| 1679994487 | Maria Arias De Lujan | Registered Nurse | 570 N Nellis Blvd Suite D1, Las Vegas, NV 89110 | 2013-12-20 |
| 1932520988 | Satoko Brilis | Registered Nurse | 570 N. Nellis Blvd., Suite D-1, Las Vegas, NV 89110 | 2013-12-18 |
| 1245651231 | Loriza Chongtai | Registered Nurse | 570 N.nellis Blvd Suite D1, Las Vegas, NV 89110 | 2013-12-18 |
| 1255752242 | Marites Navarro | Registered Nurse | 570 N. Nellis Blvd Suite D1, Las Vegas, NV 89110 | 2013-12-18 |
| 1770904781 | Karen M Atkins | Registered Nurse | 570 N. Nellis Blvd, Suite D1, Las Vegas, NV 89110 | 2013-12-17 |
| 1780020016 | Emma Jean Watson | Counselor | 3750 East Bonanza Rd Unit 155, Las Vegas, NV 89110 | 2013-05-14 |
| Find all providers in zip 89110 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
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| 1629687926 | Maria Habbi Md | Family Medicine | 501 S Rancho Dr Ste F40, Las Vegas, NV 89106-4834 | 2020-07-23 |
| 1225646805 | Shelley Elizabeth Ameduri | Family Medicine | 3943 Deluge Dr, Las Vegas, NV 89129-6481 | 2020-07-20 |
| 1659995090 | Universal Medical Alliance Inc. | Family Medicine | 6268 Spring Mountain Rd Ste 115b, Las Vegas, NV 89146-8873 | 2020-06-02 |
| 1255954640 | Partners In Primary Care Nv PC | Family Medicine | 4919 W Craig Rd, Las Vegas, NV 89130-2730 | 2020-05-20 |
| 1669095048 | Partners In Primary Care Nv PC | Family Medicine | 4813 S Eastern Ave, Las Vegas, NV 89119-6188 | 2020-05-20 |
| 1184247579 | Partners In Primary Care Nv PC | Family Medicine | 3129 N Rainbow Blvd, Las Vegas, NV 89108-4578 | 2020-05-20 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.